A Prostate Cancer Computer Aided Diagnosis Software including Malignancy Tumor Probabilistic Classification

Prostate Cancer (PCa) is the most common solid neoplasm in males and a major cause of cancer-related death. Screening based on Prostate Specific Antigen (PSA) reduces the rate of death by 31%, but it is associated with a high risk of over-diagnosis and over-treatment. Prostate Magnetic Resonance Imaging (MRI) has the potential to improve the specificity of PSA-based screening scenarios as a non-invasive detection tool. Research community effort focused on classification techniques based on MRI in order to produce a malignancy likelihood map. The paper describes the prototyping design, the implemented work-flow and the software architecture of a Computer Aided Diagnosis (CAD) software which aims at providing a comprehensive diagnostic tool, including an integrated classification stack, from a preliminary registration of images to the classification process. This software can improve the diagnostic accuracy of the radiologist, reduce reader variability and speed up the whole diagnostic work-up

Phonon-Mediated KIDs as Light Detectors for Rare-Event Search: The CALDER Project

Background suppression plays a crucial role in experiments searching for rare events, like neutrino-less double beta decay (0 $$\nu$$ DBD) and dark matter. Large mass bolometers that are among the most competitive devices in this field would largely benefit from the development of ultrasensitive light detectors, as the combined readout of the bolometric and light signals enables the particle identification. The CALDER collaboration is developing cryogenic light detectors that will match the requirements of next generation experiments: noise lower than 20 eV RMS, large active area (several cm $$^{2}$$ ), wide temperature range of operation, and ease in fabricating and operating a thousand of detectors. For this purpose, we are exploiting the excellent energy resolution and the natural multiplexed read-out provided by kinetic inductance detectors (KIDs). These devices can be operated in a phonon-mediated approach, in which KIDs are coupled to a large insulating substrate in order to increase the active surface from a few mm $$^{2}$$ to 25 cm $$^{2}$$ . Our current best prototype, based on aluminum LEKIDs, reached a baseline sensitivity of 80 eV with an overall efficiency of about 20 %

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Mineralocorticoid receptor antagonists for heart failure: a real-life observational study

Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients.Aims Mineralocorticoid receptor antagonists (MRAs) have been demonstrated to improve outcomes in reduced ejection fraction heart failure (HFrEF) patients. However, MRAs added to conventional treatment may lead to worsening of renal function and hyperkalaemia. We investigated, in a population-based analysis, the long-term effects of MRA treatment in HFrEF patients. Methods and results We analysed data of 6046 patients included in the Metabolic Exercise Cardiac Kidney Index score dataset. Analysis was performed in patients treated (n= 3163) and not treated (n= 2883) with MRA. The study endpoint was a composite of cardiovascular death, urgent heart transplantation, or left ventricular assist device implantation. Ten years\u2019survival was analysed through Kaplan\u2013Meier, compared by log-rank test and propensity score matching. At 10 years\u2019follow-up, the MRA-untreated group had a significantly lower number of events than the MRA-treated group (P<0.001). MRA-treated patients had more severe heart failure (higher New York Heart Association class and lower left ventricular ejection fraction, kidney function, and peak VO2). At a propensity-score-matching analysis performed on 1587 patients, MRA-treated and MRA-untreated patients showed similar study endpoint values. Conclusions In conclusion, MRA treatment does not affect the composite of cardiovascular death, urgent heart transplanta- tion or left ventricular assist device implantation in a real-life setting. A meticulous patient follow-up, as performed in trials, is likely needed to match the positive MRA-related benefits observed in clinical trials

LA ROBOTICA NELLA RIABILITAZIONE DEI DISTURBI SENSO-MOTORI DELL’ARTO SUPERIORE: STUDIO IN PAZIENTI AFFETTI DA ICTUS CEREBRALE

Introduzione. Lo scarso recupero funzionale dell’arto superiore è tra le conseguenze più invalidanti dell’ictus cerebri. La robotica è un possibile strumento riabilitativo dell’arto superiore paretico, fornendo un approccio terapeutico strutturato ripetitivo ed intensivo capace di promuovere la riorganizzazione corticale. Obiettivi dello studio: valutare l’efficacia di uno strumento robotico nel recupero dei disturbi senso-motori dell’arto superiore distale in pazienti con ictus e valutarne l’efficacia nel ridurre la disabilità nelle ADL e nel migliorare la Qualità di Vita. Materiali e metodi. 17 individui in esiti di ictus randomizzati in un gruppo sperimentale (terapia robotica con Amadeo) ed in uno di controllo (terapia convenzionale). Il trattamento prevedeva 12 sedute trisettimanali di 45 minuti. Gli individui sono stati valutati prima (T0), al termine (T1) e ad un mese (T2) dal trattamento. Misure primarie di outcome: Scala del Medical Research Council (MRC); Motricity Index (MI); Nine Hole Peg Test (NHPT); Action Research Arm Test (ARAT); Motor Activity Log (MAL). � � � � � � Misure secondarie di outcome: Amadeo Firefighters (AFF); Valutazione della sensibilità somatica; Barthel Index (BI). Risultati. Al confronto intra-gruppo, il gruppo sperimentale ha mostrato variazioni significative nei punteggi MRC-estensione ed ARAT tra T0 e T2; alla MI e MAL-Amount of Use tra T0 e T1 e tra T0 e T2. Il gruppo di controllo ha ottenuto risultati analoghi eccetto che nella forza di estensione delle dita, dove non mostra miglioramenti significativi. Nel confronto inter-gruppo è emersa una differenza significativa nell’ARAT-Gross movements tra T0 e T2 a favore del gruppo di controllo. Conclusioni. La terapia con robot è in grado di promuovere il recupero della motilità attiva distale dell’arto superiore paretico in esiti di ictus, in particolare nei movimenti di estensione delle dita; la sua efficacia è equiparabile a quella delle terapie convenzionali, proponendosi come integrazione ad esse

Returns in Commodities Futures Markets and Financial Speculation: A Multivariate GARCH Approach

This paper analyses futures prices for four energy commodities (light sweet crude oil, heating oil, gasoline and natural gas) and five agricultural commodities (corn, oats, soybean oil, soybeans and wheat), over the period 1986-2010. Using CCC and DCC multivariate GARCH models, we find that financial speculation is poorly significant in modelling returns in commodities futures while macroeconomic factors help explaining returns in commodities futures. Moreover, spillovers between commodities are present and the conditional correlations among commodities are high and time-varying